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NPI 1013326537

NPI 1013326537 : GOOD SAMARITAN HOSPITAL CORVALLIS : CORVALLIS, OR

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General NPI Number Information
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    NPI Number           |    1013326537
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    Entity Type          |    Organization 
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    Legal Business Name  |    GOOD SAMARITAN HOSPITAL CORVALLIS 
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Dates
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    Enumeration Date     |    08/08/2014
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    Last Update Date     |    01/30/2015
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Provider Practice Location Address
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    Address Line         |    845 SW 30TH STREET 
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    City                 |    CORVALLIS
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    State                |    OR
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    Zip                  |    97331-8629
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    Country              |    US
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    Telephone            |    541-768-7700
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    Fax                  |    541-768-9784
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Provider Business Mailing Address
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    Address Line         |    PO BOX 1189 
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    City                 |    CORVALLIS
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    State                |    OR
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    Zip                  |    97339-1189
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    Country              |    US
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    Telephone            |    541-768-7700
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    Fax                  |    541-768-9784
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Authorized Official
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    Title or Position    |    COO
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    Name                 |     BECKY  PAPE 
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    Credential           |    
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    Telephone            |    541-768-5009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    2251S0007X
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    Taxonomy Name        |    Sports Physical Therapist
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    License Number       |    
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    License Number State |    
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